UCL || Dr Helge Wurdemann || Soft Robotics for Surgery
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This document discusses the potential for soft robotics in surgery. Current rigid robotic surgery systems have limitations such as poor visualization and lack of haptic feedback. Soft robotic systems could address these issues by providing enhanced dexterity and the ability to conform to anatomical structures. The STIFF-FLOP consortium is working on developing a stiffness-controllable soft manipulator for surgical applications like total mesorectal excision. Key challenges include controlling actuation with flexible structures, sensing within soft bodies, and miniaturization for medical use. Soft robotics shows promise for improving minimally invasive surgery.
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Robotic surgery uses computer-controlled robotic devices to assist surgeons during complex procedures. The document summarizes the history, types, applications and advantages/disadvantages of medical robots. It describes how the da Vinci surgical system works and its use in otolaryngology procedures like radical tonsillectomy, obstructive sleep apnea surgery, thyroid surgery, and skull base tumor removal. While robotic surgery enables minimally invasive approaches, it also has limitations including expense, loss of haptic feedback, and a long learning curve for surgeons.
Anaesthesia for robotic surgery
Robotic surgeries are becoming most popular in field of surgical departments due to its precision of hand in many cancer surgeries. Anaesthesia in these places are quite challenging due to lack place to move , a meticulous vigilance is always required for safety of patient and conduct safe Anesthesia
Knee stiffness dr anil k jain
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Minimal access surgery
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Upper limb functional prosthesis
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Robotic hysterectomy: A review of indications, technique, outcome, and compli...
Hysterectomy is the second most common surgery performed on women after cesarean section. The advantages of minimally invasive hysterectomy such as reduced hospitalization, quick recovery with more rapid return to normal activities, and less postoperative morbidity are well known. Although most guidelines recommend that minimally invasive hysterectomy should be the standard of care, the gynecologists have been slow in adopting minimally invasive laparoscopic techniques to perform this operation. Since its approval in 2005 for gynecological surgeries, robot-assisted hysterectomy has been found to be feasible and safe both in benign and malignant indications. This significant difference is mainly due to ergonomics, endowrist movements of instruments, and stereoscopic three-dimensional magnified vision. The specific indications for hysterectomy where the robotic technology can benefit women are the ones with adhesions such as severe endometriosis, large uterus with large or multiple fibroids, early carcinoma cervix, and/or endometrial carcinoma. However the main benefit of this procedure was seen in the reduction of open surgery including conversions during laparoscopic hysterectomies. In the long run, we need to critically examine the long-term benefits and appropriate indications for robot-assisted hysterectomy especially in benign conditions, thus reducing the incidence of open surgery in gynecology. This review describes the operative procedure of robotic hysterectomy in eight steps.
Upper Limb Prosthetics - Dr Om Prakash
This document provides information on upper limb prostheses. It discusses the history of prosthetics, levels of amputation, types of prosthetic systems (passive, body-powered, externally powered, hybrid), components (socket, suspension, control mechanisms, terminal devices), and considerations for prosthetic selection and use. The key points are that upper limb loss can be devastating, prosthetics can replace some hand functions but not sensation, and the appropriate prosthesis depends on the amputation level, expected use, and individual factors.
Robotic Sacrocolpopexy OLV
Robotic sacrocolpopexy is a minimally invasive technique for repairing pelvic organ prolapse that provides excellent functional and anatomical results with limited risks. It allows for a complete correction of prolapse in the anterior, posterior, and apical compartments using a single approach. Studies show robotic sacrocolpopexy has comparable outcomes to open surgery with less blood loss and shorter hospital stays. While the technique has a learning curve, it may have advantages over conventional laparoscopy due to its 3D visualization and instrument dexterity.
Vypro mesh presentation today1
This document discusses a study that evaluated the sublay retromuscular technique for ventral incisional hernia repair using lightweight Vypro mesh versus standard heavyweight Prolene mesh. 30 patients with moderate sized hernias were divided into two groups, with one group receiving Vypro mesh and the other receiving Prolene mesh via the sublay retromuscular technique. The study aims to compare postoperative complications, chronic pain, and recurrence rates between the two mesh types.
Laparoscopic Dissection Techniques
Dissection is defined as the separation of tissues with hemostasis. It consists of a sensory visual and tactile component, an access component involving tissue manipulation, and instrument maneuverability.
The Surgery for Rectal Cancer
This document discusses surgical considerations for rectal cancer, including:
1. The total mesorectal excision (TME) technique aims to remove the mesorectum containing all lymph nodes, leading to low local recurrence rates of 3-4% after 5-10 years.
2. Pre-operative chemoradiotherapy can downstage tumours and improve survival, especially for T3/T4 tumours.
3. A modified TME removing the mesorectum at least 5cm below the tumour is acceptable for high and mid rectal cancers, as distal spread beyond this is rare.
4. Good surgical outcomes depend on meticulous technique, surgeon experience operating in the pelvis, and multidis
Trans-anal Endoscopic Microsurgery TEM
Trans-anal Endoscopic Microsurgery TEM; Trans-anal Endoscopic operation TEO; Trans-anal Endoscopic Surgery TES.
Prosthetics
A prosthesis is an artificial replacement for any part of the body that is missing. It is designed to replace the function and appearance of the missing limb as much as possible. Prostheses for lower and upper limb amputations are prescribed based on the level and cause of amputation. The main components of a prosthesis are the socket, suspension system, control system, and terminal device. The socket provides an intimate fit with the residual limb. Suspension systems like belts and harnesses help hold the prosthesis securely. Control systems can be body-powered using cables or externally powered using batteries. Terminal devices replace missing hands or feet. The goal is to restore ambulation and functional tasks using a prosthesis.
Robotic surgery in ENT
This document discusses the history and applications of robotic surgery in ENT. It begins with the origins of robotics in the 1920s and the emergence of surgical robotics from advances in other fields. The da Vinci surgical system is currently the most widely used system, allowing 7 degrees of freedom of motion and 3D visualization. Initial ENT applications included transoral surgery and thyroid procedures. Transoral robotic surgery (TORS) allows improved access and resection for tumors of the tonsil, base of tongue, and larynx. Robotic thyroid surgery reduces incision sizes. Future areas may include sinus and skull base procedures as technology advances.
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Anaesthetic concerns in Robotic assisted urological surgery
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Robotic hysterectomy: A review of indications, technique, outcome, and compli...
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- 1. UCL Mechanical Engineering UCL Robotics UCL Mechanical Engineering UCL Robotics Future Health: Soft Robotics for Surgery Dr Helge Wurdemann Lecturer in Medical Devices
- 2. Image source: www.dezeen.com - The Miro Surge system
- 3. Image source: Laparoscopic liver surgery at UPMC
- 4. • It can be problematic to change surgical targets inside the abdomen, and when needed to work in different anatomical districts, it can become necessary to move the entire robotic trolley. • Difficulties with the positioning of current camera systems often lead to a suboptimal visualization of the field ‐ surgical manoeuvres may be influenced. • Usually additional support is required by a laparoscopic assistant at the patient’s side. • The current da Vinci robotic system does not provide the surgeon with haptic feedback of the handled tissues. This, added to the strong mechanical power of the robotic arms, can lead to tissue tears. Dexterity constraints of rigid-link robots
- 5. What about soft systems? Or even soft-stiff systems?
- 6. Imagesource:DKFindout.com Professor Kaspar Althoefer Queen Mary University Dr Helge Wurdemann University College London STIFFness controllable Flexible and Learnable manipulator for surgical OPerations
- 8. The STIFF-FLOP consortium Scientific Experts from Biology Scientific Experts from Medicine Scientific Experts from Engineering
- 9. Total Mesorectal Excision (TME) based on presentation by Prof Alberto Arezzo, University of Turin TOTAL MESORECTAL EXCISION (TME)TOTAL MESORECTAL EXCISION (TME)
- 10. TROCARS’ POSITION A number of access points fairly wide-spread across the abdomen are needed. Employing da Vinci requires frequent repositioning of overall system as well as human assistance near the patient. based on presentation by Prof Alberto Arezzo, University of Turin Total Mesorectal Excision (TME) TROCARS’ POSITION
- 11. • Mobilization of Splenic Flexure • Mobilization of Sigmoid Colon / Toldt Fascia • Incision of Pelvic Peritoneum • Ligation of Inferior Mesentric Artery (IMA) • Mobilization of Left Colon / Gerota Fascia • Ligation of Mesentric Vein • Posterior TME • Lateral TME • Posterior TME (2) • Anterior TME (Male/Female) • Section of Rectum • Anastomosis Procedure Elements (TME):
- 12. Posterior TME
- 16. • Actuation/sensor interference (drastically changes the reading!). • Chamber cross-section area changes (nonlinear actuation). • Chamber geometrical centers shifted inwards • Resulting bending moment smaller. Challenges:
- 17. Flexible and High Dexterous 2-module Soft Robot
- 19. Future Challenges Floppy to Stiff – Stiff to Floppy? Motion Control Sensing in a Soft Structure Integration Miniaturisation/Fabrication
Editor's Notes
- Inspiration from the octopus….no backbone, bending, elongation, stiffening.